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Tips For Recovering After A Marathon

October 8, 2018

Congratulations to the hundreds of runners who finished the 23rd annual Steamtown Marathon on Sunday in Scranton. Most, if not all, of you are waking up this morning with a little less jump in your step than you had yesterday. Runners, by nature, are very active (often hyperactive) people who may have difficulty sitting and resting, even the day after a marathon. However, today should be a day of rest; you earned it. It is not wise to ignore the pain and stiffness in your muscles and joints. So I would like to offer some words of wisdom, based on science, to encourage you to adequately rest and allow your body to recover. It’s important to be aware of the effects that running 26.2 miles has on the body, according to Jim Peskett of RunNow.com: Musculoskeletal system One of the most obvious effects of running a marathon is significant muscle and joint pain and stiffness. It will set in after you sit for a while and attempt to get up and move around. For most, it will be more pronounced the day after the marathon, as you get out of bed and limp to the bathroom. Studies show that the leg muscles (especially the calf muscles) display significant inflammation and necrosis (dead tissue) in the fibers of the muscle. In other words, the trauma to the muscles is so severe that tissue damage causes muscle cells to die. Studies have found that muscle strength, power and endurance are compromised and require significant time to recover — sometimes as long as four to six weeks. Also, many runners report severe bone and joint pain after the race. Some studies report findings of microfractures or bone bruising from the repeated and prolonged pounding of the marathon. The stress on the joints may be related to weight and body type, running shoes, running style and mechanics. While not dangerous, again, it is important to respect the stress placed on the body and allow adequate healing. Listen to your body. Cellular damage Creatine kinase is an enzyme found in the brain, skeletal muscles and heart. It is found in elevated levels in the presence of cellular damage to these tissues, for example, after a heart attack. Similarly, significantly elevated creatine kinase levels are found in the blood of runners up to four days post-marathon, demonstrating extensive tissue damage at the cellular level. It’s important to note that these enzyme markers are present, even if a runner does not experience muscle soreness. So, adequate rest for healing and recovery is required, regardless of soreness. Immune system It is not a coincidence that runners are more likely to contract colds and flu after intensive training or running 26.2 miles. The immune system is severely compromised after a marathon, and without adequate recovery a runner can become ill and ultimately lose more training time or will underperform. Recovery tips Here are 10 tips to speed up your recovery after a marathon, from runnersworld.com. Some of these are for immediately after the race, so obviously it’s too late for Steamtown, but they apply to any marathon: Walk: Once you cross the finish line, keep walking for 10-15 minutes after the race to gradually lower your heart rate and prevent a buildup of lactic acid in your traumatized muscles. Eat and drink: Eat small snacks in the first hour after the race and avoid a big meal later in the day. Drink 24 ounces of water for every 2 pounds of weight loss after the race. Relax: If there was ever a time to enjoy a good movie or television show, it is after a marathon. Just get up and walk around every 20-30 minutes. Elevate your legs: While relaxing, elevating your legs is a good idea to improve circulation. If you’re traveling by car or plane for longer than one hour, wear compression socks while you elevate. Roll and massage: Wait about three hours after the race before you roll out and massage your muscles. Make sure you hydrate first. Stretch: Also wait three hours to gently stretch your tight muscles. Be gentle because the muscles are already traumatized. Do not run: The research clearly states that running too soon will slow down full recovery. Some elite runners take a full month off after the marathon, instead doing yoga and cross-training. But at least follow a schedule like this: One week after the race: No running. Do yoga, swim, walk, etc. Two weeks after the race: If you no longer have pain, continue cross-training and gradually introduce light, soft running for 30 to 60 minutes. Three weeks after the race: Gradually increase the time, distance and speed if you are pain free. Three big myths Myth 1: If I don’t have pain, then I did not damage my body and I can run again soon after the marathon. As stated above, enzyme levels that indicate cellular damage to the tissues are present in the post-marathon runner, even in those without significant pain. Myth 2: Energy drinks with caffeine are the best way to re-energize my body and speed up my recovery. In addition to rest, drink, drink, drink — 24 ounces of water for every 2 pounds you lose after the marathon. This is based on pre- and post-exercise weight. You just burned 2,600 calories, so avoid diet soft drinks. You need the glucose (sugar) boost. Also, don’t drink alcohol, and use minimal amounts of caffeine (the equivalent of 1-2 cups of coffee). First, drink plenty of water and sports drinks (such as Gatorade) to prevent a diuretic like caffeine from messing up your fluid balance. Myth 3: If I don’t run, I will lose all of my conditioning in one week. Studies clearly show that the VO2 Max (the best measurement of a runner’s endurance and fitness), is unchanged after one week of inactivity. And, after two weeks, the loss is less than 6 percent and can be regained quickly. Moreover, it’s important to remember that without adequate rest and recovery, performance is comprised, not by the loss of VO2 Max, but by musculoskeletal tissue damage, which renders the leg muscles weaker. PAUL J. MACKAREY, P.T., D.H.Sc., O.C.S., is a doctor in health sciences specializing in orthopedic and sports physical therapy. He is in private practice and an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. His column appears every Monday. Email: drpmackarey@msn.com.

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